Digital Commons Network^™

Palliative Medicine Integration In The Usa: Cancer Centre Executives’ Attitudes, Joseph Chen, Allison De La Rosa, Dejian Lai, Rony Dev, Frances Lee Revere, David Lairson, Paige Wermuth, Eduardo Bruera, David Hui

Faculty, Staff and Student Publications

OBJECTIVES: To compare cancer centre (CC) executives' attitudes towards palliative care between National Cancer Institute-designated CCs (NCI-CCs) and non-NCI-designated CCs (non-NCI-CCs) in 2018 and to examine the changes in attitudes and beliefs between 2009 and 2018.

METHODS: CC chief executives at all NCI-CCs and a random sample of non-NCI-CCs were surveyed from April to August 2018. Twelve questions examined the executives' attitudes towards palliative care integration, perceived barriers and self-assessments. The primary outcome was agreement on the statement 'a stronger integration of palliative care services into oncology practice will benefit patients at my institution.' Survey findings from 2018 were compared …

Implementing A Hearing Screening Readiness Assessment Tool For Preterm And Term Neonates In The Newborn Intensive Care Unit: A Pilot Project, Mckenzie Blatt, Adrienne Johnson, Jennifer L. Hamilton, Carly Alston, Belinda Chan

Journal of Early Hearing Detection and Intervention

Newborn intensive care unit (NICU) patients are at risk for hearing loss. Early detection mitigates consequences of speech and language delay. The Joint Committee on Infant Hearing (JCIH) recommends hearing screening (HS) on all infants by 1 month of age. Often hearing screening is performed around the time of NICU discharge, often beyond JCIH recommendations. Automated auditory brainstem response (AABR) screening can be performed once an infant reaches 32 to 34 weeks corrected gestational age (GA). Our project aimed to reduce HS delay among NICU infants. We created and implemented a HS assessment tool defining gestational age and medical stability …

Journal Of Early Hearing Detection And Intervention: Volume 8 Issue 1, Pages 1-68

Journal of Early Hearing Detection and Intervention

No abstract provided.

Utilizing Natural Language Processing For Automated Clinical Text Review: Identification Of Care Preference Documentation In Patients’ Discharge Summaries, Saksham Arora

Computer Science Senior Theses

Improving patient-centered care necessitates accurate documentation of care preferences, a crucial aspect often underrepresented in administrative data. Most studies apply care documentation to specific patient populations, rather than more appropriately broad population of `seriously ill' patients. This paper addresses this gap by leveraging transformer-based machine learning models, exhibiting an improvement over traditional keyword-based search methods in identifying care preference documentation.

In order to capture a broad spectrum of seriously ill patients, we matched decedent patients to non-decedent counterparts by utilizing a propensity score matching, accounting for important variables like age, gender, primary diagnoses and commodities. We trained and fine-tuned Bio_ClinicalBERT …

Race-Free Estimated Glomerular Filtration Rate Equation In Kidney Transplant Recipients: Development And Validation Study, Marc Raynaud, Solaf Al-Awadhi, Ivana Juric, Gillian Divard, Yannis Lombardi, Nikolina Basic-Jukic, Olivier Aubert, Laurence Dubourg, Ingrid Masson, Christophe Mariat, Dominique Prié, Vincent Pernin, Moglie Le Quintrec, Timothy S Larson, Mark D Stegall, Boris Bikbov, Piero Ruggenenti, Laurent Mesnard, Hassan N Ibrahim, Marie Bodilsen Nielsen, Arthur J Matas, Brian J Nankivell, Stan Benjamens, Robert A Pol, Stephan J L Bakker, Xavier Jouven, Christophe Legendre, Nassim Kamar, Byron H Smith, Hani M Wadei, Antoine Durrbach, Flavio Vincenti, Giuseppe Remuzzi, Carmen Lefaucheur, Andrew J Bentall, Alexandre Loupy

Faculty, Staff and Student Publications

OBJECTIVE: To compare the performance of a newly developed race-free kidney recipient specific glomerular filtration rate (GFR) equation with the three current main equations for measuring GFR in kidney transplant recipients.

DESIGN: Development and validation study SETTING: 17 cohorts in Europe, the United States, and Australia (14 transplant centres, three clinical trials).

PARTICIPANTS: 15 489 adults (3622 in development cohort (Necker, Saint Louis, and Toulouse hospitals, France), 11 867 in multiple external validation cohorts) who received kidney transplants between 1 January 2000 and 1 January 2021.

MAIN OUTCOME MEASURE: The main outcome measure was GFR, measured according to local practice. …

Improving Patient Self-Efficacy, Readiness, And Completion Of Advance Care Planning Documents Using Prepare Documents And Advance Care Planning Group Referral, Marie Vassiliadis

Doctor of Nursing Practice Final Manuscripts

Advance Care Planning (ACP) is an ongoing discussion about medical decision making between a provider, patient, and support person. ACP can also include legal documentation in the form of an advance directive (AD). Nationally, only 36.7% of adults complete any form of AD for end-of-life care. Recently, ACP has become an important quality metric that many organizations are prioritizing. The purpose of this evidence-based project is to improve ACP readiness, self-efficacy, and documentation among patients at an internal medicine clinic using the PREPARE program and referral to an ACP group meeting. PREPARE for Your Care is an online program aimed …

Charles Brooks Sessions

African American Funeral Programs

No abstract provided.

A Case Of Hemorrhagic Myositis Associated With Prophylactic Heparin Use In Dermatomyositis, Mery Bartl, Jose G. Gomez Casanovas, Christine E. Loftis, Laura Rincon-Rueda, Andres R. Suarez

School of Medicine Publications

Dermatomyositis (DM) is a rare systemic autoimmune disease that is associated with inflammation of the skin and muscles. It typically presents with weakness of the proximal muscles along with characteristic skin lesions such as Gottron's papules and heliotrope rash. One of the most feared complications of this disease is the appearance of spontaneous hemorrhagic myositis, as most reported cases are fatal. The mechanism or risk factors of this condition have not been elucidated; however, prophylactic anticoagulation has been correlated with it in previous case reports, although idiopathic hemorrhagic myositis may also be present. We present a case of spontaneous intramuscular …

A Literature Review On Understanding, Solidifying, And Expanding The Role Of Art Therapy In Death And Dying, Deborah D. Clark

University Honors Theses

The purpose of this literature review is to weave together an understanding of what research exists around art therapy in death and dying, what the role of art therapy is in end-of-life care and education, and determine what gaps exist for further study. When it comes to the topic of death and dying, most of us would agree that end-of-life care is extremely important, though this agreement often falls apart regarding what that care looks like, and how we do (or don't) talk and learn about death and dying. This review argues for an integrated holistic model of care concerning …

Je Ne Me Souviens Pas: Pensioned Veterans From French Canada’S 22nd Battalion, Serge Marc Durflinger

Canadian Military History

An examination of the pension files of men having served in the 22nd Battalion (canadien-français), the Canadian Corps’ only French-speaking line battalion, situates veterans into a specific ethno-linguistic and, more generally, socio-economic context. This article seeks to illuminate some of the many personal crises that could, and commonly did, afflict veterans, their families and their survivors. It demonstrates that beyond the devastation of serious physical or psychological wounding, many of Canada’s returned men, perhaps far more than we imagined, suffered persistent ill health, financial distress and family estrangement. Almost without exception, the sixty 22nd Battalion case files examined …

The Scrivener's Error: How Bankruptcy Judges Overrule Health Experts On Medicare Decisions, Nicolas C. Oehler

Akron Law Review

There is a circuit split over the interpretation of 42 U.S.C. § 405(h), which requires providers to exhaust their remedies with the Department of Health and Human Services (HHS) before proceeding to court. This split originates from a recodification that omitted several jurisdictional grants from § 405(h), leaving courts to decide whether to continue interpreting the statute as Congress intended or begin interpreting the statute’s plain language. Complicating this split, a backlog of claims in HHS’s appeal systems prevents speedy adjudication. This delay leaves providers searching for other adjudicatory options for their Medicare claims, such as bankruptcy courts.

As initially …

Leptomeningeal Myelomatosis: An Unusual Presentation Of Multiple Myeloma, Vasu Malhotra, Vikas Malhotra, Kenneth Shain

HPD Articles

Multiple myeloma (MM) is characterized by the neoplastic proliferation of plasma cells producing a monoclonal immunoglobulin. Although neurological complications are commonly seen in MM, they most frequently occur due to spinal cord compression by bony lesions, paraprotein-related neuropathy, hypercalcemia, hyper viscosity, or amyloidosis. Less than 1% of patients with MM present with a leptomeningeal disease. We present a case of a leptomeningeal myeloma in a 61-year-old woman with known relapsed MM who presented with headaches and dysphagia. We present this case to alert clinicians to keep a high index of suspicion in cases of Multiple Myeloma presenting with non-specific neurological …

Study Protocol: Type Iii Hybrid Effectiveness-Implementation Study Implementing Age-Friendly Evidence-Based Practices In The Va To Improve Outcomes In Older Adults, Kirstin Manges Piazza, Laura Ellen Ashcraft, Liam Rose, Daniel E. Hall, Rebecca T. Brown, Mary Elizabeth (Libby) Bowen, Shahrzad Mavandadi, Alison C. Brecher, Shimrit Keddem, Bruce Kiosian, Judith A. Long, Rachel M. Werner, Robert E. Burke

College of Population Health Faculty Papers

Background

Unmet care needs among older adults accelerate cognitive and functional decline and increase medical harms, leading to poorer quality of life, more frequent hospitalizations, and premature nursing home admission. The Department of Veterans Affairs (VA) is invested in becoming an “Age-Friendly Health System” to better address four tenets associated with reduced harm and improved outcomes among the 4 million Veterans aged 65 and over receiving VA care. These four tenets focus on “4Ms” that are fundamental to the care of older adults, including (1) what Matters (ensuring that care is consistent with each person’s goals and preferences); (2) …

Improved Education For Caregivers Of Hospice Heart Failure Patients To Reduce Hospital Admissions: An Integrative Review, Sierra Spain Sanford

Doctoral Dissertations and Projects

Heart disease is the second-leading cause of death in the United States, excluding the COVID-19 pandemic. Despite being the leading cause of death, heart failure only comprises 15% of hospice deaths and remains the most likely to be discharged from hospice services due to acute hospitalizations compared to all other hospice diagnoses. This leads to low patient and family satisfaction as well as high medical costs. This integrative review synthesizes current published evidence highlighting the need to improve caregiver education for symptom management of terminal heart failure patients in hospice. The literature supports that improved caregiver education can lead to …

Histological Transformation To Gliosarcoma With Combined Braf/Mek Inhibition In Braf V600e Mutated Glioblastoma, Blessie Elizabeth Nelson, Neha K Reddy, Jason T Huse, Behrang Amini, Mirella Nardo, Mohamed Gouda, Shiao-Pei Weathers, Vivek Subbiah

Faculty, Staff and Student Publications

The identification of BRAF V600 mutation in multiple cancers beyond melanoma and the development of combined BRAF and MEK targeting agents have altered the landscape of tissue-agnostic precision oncology therapies with an impact on survival outcomes. Despite initial efficacy, resistance emerges, and it is pertinent to identify putative resistance mechanisms. We report a case of recurrent glioblastoma (GBM) harboring BRAF V600E alteration who initially responded to combined BRAF + MEK inhibition and subsequently developed treatment resistance by histological transformation to gliosarcoma and acquisition of oncogenic KRAS G12D and an NF1 L1083R mutation. This documented case represents an initial evidence of …

"My Dog Is In Teletherapy With Me": The Impact Of A Pet Dog On Their Owner's Teletherapy Session, Carlette Anne Layne

Doctoral Dissertations and Projects

The connection between humans and animals has led to practices such as animal-assisted therapy, equine therapy, service animals, and pet ownership. Strong bonds and attachments can form between pet owners and their pets. It is no wonder that owning a pet is commonplace in the United States. Many pet owners identify their pet as a member of their family. In addition to companionship, research has indicated that pet ownership can have health benefits, reduce stress, increase empathy, and facilitate openness. In a therapeutic setting, the presence of a pet may comfort its owner simply by being near them. The ease …

The Relationship Between Perceived Self-Efficacy And Retention Of New Hospice Volunteers, Joann Erb

Dissertations

As the hospice concept becomes more popular, there is an increased need for hospice volunteers. Hospice volunteer coordinators are seeking methods that will help enhance volunteer recruitment and retention. One screening method that has been used by employment and educational counselors to identify characteristics associated with success is the measurement of self-efficacy.

Studies of hospice volunteer retention have addressed previous volunteer experience, religiosity, and personality type. While there has been consistency in some characteristics as predictors of success, contradicting results exist. An individual's level of comfort around death issues has been suggested as a better predictor than death anxiety. This …

Nursing Students' Intention To Work With The Elderly After Graduation: A Qualitative Study, Terri Murabito

Dissertations

America's population is aging. More than one in five Americans will be over 65 by 2030. These numbers are expected to challenge existing healthcare systems. The recruitment and retention of qualified, competent registered nurses (RNs) to care for this vulnerable population have become urgent. However, undergraduate baccalaureate nurses consistently report geriatric nursing as the least preferred clinical area to in work after graduation. To understand how graduating nurses discern their career intentions, a basic qualitative study was undertaken using Ajzen's theory of planned behavior as an underlying theoretical framework. The purpose of the study was to understand and interpret nursing …

Implementation Of An Emergency Medicine Palliative Care Curriculum For Emergency Medicine Residents, Dylan Rupska, Travis Hase, Ryan Tabor, Cindy Ndiaye, Maggie Putnam

Scientific Day

No abstract provided.

Medstopper: An Online Tool To Assist With Deprescribing Medications In Patients Enrolled In Home Hospice, Paige Scholer, Kavita Sharma, Kanwardeep Singh, Lori Cook, Jenny Kaldor, Tamara Schulz, Sarah Riutta

Scientific Day

No abstract provided.

Review Of Octreotide Use For End-Of-Life Symptom Management By Indication In An Inpatient Hospice Setting, Lisa Peterson, Kavita Sharma, Sarah Riutta

Scientific Day

No abstract provided.

Knowledge Assessment Of Resident Physicians: Palliative And Hospice Care Basics, A Quality Improvement Project, Kaitlin Pellicano, Breana Chandra, Andrew Gregory, Kavita Sharma, K Lu, Sarah Riutta, James Adefisoye

Scientific Day

No abstract provided.

List Of Events For 49th Annual Scientific Day, Advocate Aurora Health

Scientific Day

No abstract provided.

Event Recap Flyer And Winners, Advocate Aurora Health

Scientific Day

Recap flyer from the 49th Annual Advocate Aurora Scientific Day, including list of award recipients.

Transmission Of Mycobacterium Tuberculosis To Healthcare Personnel Resulting From Contaminated Bone Graft Material, United States, June 2021–August 2022, Ruoran Li, Molly Deutsch-Feldman, Tamasin Adams, Michelle Law, Chinpar Biak, Erika Pitcher, Marci Drees, Alfonso C Hernandez-Romieu, Thomas D Filardo, Tracina Cropper, Angelica Martinez, W Wyatt Wilson, Sandy P Althomsons, Sapna Bamrah Morris, Jonathan M Wortham, Isaac Benowitz, Noah G Schwartz, Kelly White, Maryam B Haddad, Janet B Glowicz, Bone Allograft Tuberculosis Investigators

Faculty, Staff and Student Publications

A nationwide tuberculosis outbreak linked to a viable bone allograft product contaminated with Mycobacterium tuberculosis was identified in June 2021. Our subsequent investigation identified 73 healthcare personnel with new latent tuberculosis infection following exposure to the contaminated product, product recipients, surgical instruments, or medical waste.

Improving The Use Of Advance Care Planning In Assisted Living Facilities, Johnpaul King

Dissertations

Ensuring patients receive care in the fashion they so choose at the end of life should be considered and addressed upon any admission process. The project site noted many unnecessary, repeated emergency room (ER) visits for residents so an evidence-based solution was sought. The purpose of this quantitative, quality improvement project was to determine if the implementation of the Carolina Caring Hospice Agency ACP (CCHAACP) toolkit would impact ACP implementation and reduce ER visits among residents in an assisted living facility (ALF) in Western North Carolina over four weeks. Orem's selfcare theory was the framework of the project. Data was …

Osteosarcoma Of The Larynx: A Case Report And Review Of Literature, Arup Ganguly, Rodolfo Garza, Vinayak Jain, Shravan Narmala

School of Medicine Publications

The most common malignant laryngeal tumors are squamous cell carcinomas (SCCs), and other types such as sarcomas are rare. Osteosarcomas of the larynx are extremely rare within the subset of sarcomas, with very few cases reported in the literature. This cancer has a predilection for elderly males, in the sixth to eighth decades of life. Associated symptoms include hoarseness, stridor, and dyspnea. It is known to spread early and has a high rate of recurrence. We present the case of a 73-year-old male, a former smoker, who presented to the clinic with severe dyspnea and progressive hoarseness and was found …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

The Dance/Movement Embodied Experience Of Grief And Loss Using The Five Senses: Development Of A Clinical Method, Yarmisha Cofield

Expressive Therapies Capstone Theses

According to recent grief and loss research, creative arts therapy can help people heal after losing something or someone. However, there is little research to support the use of dance/movement therapy (DMT) in the adult population. This literature review investigated grief and loss, with a particular emphasis on embodied grief and how and where grief is carried in the physical body. Furthermore, this study of the literature extended on the implementation of DMT and the five senses with adults experiencing embodied grief, as well as body-based techniques to assist these individuals in understanding their loss. This was an essential subject …

The Benefits Of Art Therapy On Stress And Anxiety Of Oncology Patients During Treatment, Helen Shiepe

Expressive Therapies Capstone Theses

Within the last ten years research on art therapy and its positive impact on oncology patients’ stress and anxiety during treatment has been minimal. Oncology patients whether they are children or adults when diagnosed experience similar reactions due to their diagnosis, treatment, and in some cases end of life care. The current question is whether or not art therapy does have a positive impact on decreasing the stress and anxiety with oncology patients while undergoing treatment. Deane, Fitch & Carmen (2000), discussed art therapy as a healing art that is “intended to integrate physical, emotional, and spiritual care by facilitating …